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75岁以上老年患者腹腔镜辅助结直肠癌手术短期疗效评估:一项多机构研究(YSURG1401)

Evaluation of short-term outcomes of laparoscopic-assisted surgery for colorectal cancer in elderly patients aged over 75 years old: a multi-institutional study (YSURG1401).

作者信息

Kazama Keisuke, Aoyama Toru, Hayashi Tsutomu, Yamada Takanobu, Numata Masakatsu, Amano Shinya, Kamiya Mariko, Sato Tsutomu, Yoshikawa Takaki, Shiozawa Manabu, Oshima Takashi, Yukawa Norio, Rino Yasushi, Masuda Munetaka

机构信息

Department of Surgery, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.

The Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, 241-8515, Japan.

出版信息

BMC Surg. 2017 Mar 21;17(1):29. doi: 10.1186/s12893-017-0229-7.

Abstract

BACKGROUND

The short-term outcomes of laparoscopic-assisted surgery for colorectal cancer (LAC) have not been fully evaluated in elderly patients. The aim of this study was to compare the short term surgical outcomes of LAC between the patients older than 75 years and those with non-elderly patients.

METHODS

This retrospective multi-institutional study selected patients who underwent LAC between April 2013 and March 2014 at Yokohama City University Hospital and its related general hospitals. The patients were categorized into two groups: elderly patients (>75 years of age: group A) and non-elderly patients (<75 years of age: group B). Surgical outcomes and post operative complications were compared between the two groups.

RESULTS

A total of 237 patients were evaluated in the present study. Eighty-four patients were classified into group A, and 153 into group B. Preoperative clinicopathological outcomes demonstrated no significant differences except for the ASA score. When comparing the surgical outcomes between group A and group B, the rate of conversion to open procedure (3.6% vs 5.2%, P = 0.750), median operation time (232 min vs 232 min, P = 0.320), median blood loss (20 ml vs 12 ml, P = 0.350). The differences were not significantly different in the surgical outcomes. The incidences of > grade 2 post operative surgical complications were similar between two groups ((19.0% vs 15.7%, p = 0.587). No mortality was observed in this study. The length of postoperative hospital stay was also similar (10 days vs 10 days, p = 0.350).

CONCLUSIONS

The present study suggested that LAC is safe and feasible, regardless of the age of the patient, especially for elderly patients who may be candidates for colon cancer surgery.

摘要

背景

老年患者接受腹腔镜辅助结直肠癌手术(LAC)的短期疗效尚未得到充分评估。本研究旨在比较75岁以上患者与非老年患者LAC的短期手术疗效。

方法

这项回顾性多机构研究选取了2013年4月至2014年3月在横滨市立大学医院及其相关综合医院接受LAC的患者。患者分为两组:老年患者(>75岁:A组)和非老年患者(<75岁:B组)。比较两组的手术疗效和术后并发症。

结果

本研究共评估了237例患者。84例患者被分类为A组,153例为B组。术前临床病理结果显示,除美国麻醉医师协会(ASA)评分外,无显著差异。比较A组和B组的手术疗效,开腹手术转换率(3.6%对5.2%,P = 0.750)、中位手术时间(232分钟对232分钟,P = 0.320)、中位失血量(20毫升对12毫升,P = 0.350)。手术疗效差异无统计学意义。两组术后2级以上手术并发症发生率相似(19.0%对15.7%,p = 0.587)。本研究未观察到死亡病例。术后住院时间也相似(10天对10天,p = 0.350)。

结论

本研究表明,无论患者年龄如何,LAC都是安全可行的,尤其对于可能适合结肠癌手术的老年患者。

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[Is age a risk factor for laparoscopic colorectal surgery?].[年龄是腹腔镜结直肠手术的危险因素吗?]
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Outcome of Colorectal Surgery in Elderly Populations.老年人群结直肠手术的结果
Ann Coloproctol. 2016 Aug;32(4):139-43. doi: 10.3393/ac.2016.32.4.139. Epub 2016 Aug 31.
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Laparoscopic surgery for colorectal cancer: advantages and challenges.结直肠癌的腹腔镜手术:优势与挑战
Updates Surg. 2016 Dec;68(4):421-422. doi: 10.1007/s13304-016-0379-7. Epub 2016 Jun 6.
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Laparoscopic colorectal surgery: Is it beneficial in the over 80s?腹腔镜结直肠手术:对80岁以上老人有益吗?
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